Exercise Training in Patients With Chronic Heart Failure and Atrial Fibrillation

Document Type

Article

Publication Date

4-4-2017

Publication Title

Journal of the American College of Cardiology

Abstract

BACKGROUND: The safety and efficacy of aerobic exercise in heart failure (HF) patients with atrial fibrillation (AF) has not been well evaluated.

OBJECTIVES: This study examined whether outcomes with exercise training in HF vary according to AF status.

METHODS: HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) randomized 2,331 ambulatory HF patients with ejection fraction ≤35% to exercise training or usual care. We examined clinical characteristics and outcomes (mortality/hospitalization) by baseline AF status (past history of AF or AF on baseline electrocardiogram vs. no AF) using adjusted Cox models and explored an interaction with exercise training. We assessed post-randomization AF events diagnosed via hospitalizations for AF and reports of serious arrhythmia caused by AF.

RESULTS: Of 2,292 patients with baseline rhythm data, 382 (17%) had AF, 1,602 (70%) had sinus rhythm, and 308 (13%) had "other" rhythm. Patients with AF were older and had lower peak Vo

CONCLUSIONS: AF in patients with chronic HF was associated with older age, reduced exercise capacity at baseline, and a higher overall rate of clinical events, but not a differential response to exercise training for clinical outcomes or changes in exercise capacity. (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training [HF-ACTION]; NCT00047437).

Medical Subject Headings

Aged; Atrial Fibrillation; Exercise; Exercise Tolerance; Female; Heart Failure; Humans; Male; Middle Aged; United States

PubMed ID

28359513

Volume

69

Issue

13

First Page

1683

Last Page

1691

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